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Asiatic black bears (Ursus thibetanus) are kept illegally for bile farming in Vietnam, and are classified as vulnerable by the IUCN. Bears are "milked" for bile, used in traditional Chinese medicine, by repeated needle puncture of the gallbladder, or by use of an indwelling catheter, or creation of a fistula. Bears rescued from bile farms have demonstrated a very high incidence of gallbladder and liver disease related to the practice of "milking" bile, and previous studies have shown almost half of fistulated bears later died of liver and gallbladder tumours, believed a consequence of the chronic inflammation and infections caused by invasive bile collection techniques. Even in non-fistulated bears, almost all bears have chronic cholecystitis (infection/inflammation of the gallbladder). Many rescued bears in a number of charities in Asia have had to have a cholecystectomy (gallbladder removal) performed by open abdominal surgery to remove a diseased gallbladder, and to try prevent the later development of malignant liver and gallbladder tumours. This video records the worlds first gallbladder removal performed by minimally invasive surgical technique in bears rescued from bile farming. he technique has notable welfare benefits over the standard open abdominal surgical approach and prolonged recovery. All bears made a rapid recovery, and returned to normal activities such as swimming, climbing, and interacting with other bears within 1 week of surgery. Open abdominal surgery is associated with large, painful wounds, and the prolonged healing time necessitates keeping bears confined in very small cages for 6 weeks or more to allow healing to occur. Open surgery to remove the gallbladder in humans is associated with high levels of post-operative pain, prolonged hospitalisation, slow recovery, increased risk of dehiscence (the wound breaking open), increased risk of infection, and an increased risk of developing a hernia (needing a second corrective surgery to repair). In human hospitals in developed countries, this type of surgery has been almost entirely replaced by laparoscopic, so-called "keyhole surgery" cholecystectomy, also referred to as minimally invasive surgery. Laparoscopic cholecystectomy is now firmly established as the gold standard for gallbladder removal in human patients. Keyhole surgery has been successfully performed in numerous species of wildlife in rescue centres and zoological collections, and has been well demonstrated to result in faster recoveries. Animal patients need much less post-operative care, and have a lower risk of developing post-operative infections or complications. This veterinary trip was made by Royal Zoological Society of Scotland (RZSS) veterinary surgeon Romain Pizzi, and wildlife anaesthetist Jonathan Cracknell, to the Free The Bears (FTB) Hon Me rescue centre in Vietnam's Mekong Delta in November and December 2010. Working with FTB's veterinary team , the team gave all of the centres rescued Asiatic black bears (Ursus thibetanus) a comprehensive general health check under anaesthesia, including haematology, serum biochemistry testing, and abdominal ultrasonography. Numerous bears had minimally invasive laparoscopic abdominal examinations and liver biopsies were taken for histological assessment, and bears that were found to have significantly diseased and fibrotic gallbladders with abdominal adhesions , had their gallbladders removed by minimally invasive laparoscopic cholecystectomy (keyhole surgery). Sponsors and Donors were the Royal Zoological Society of Scotland, Surgical Innovations, Woodleys Veterinary Instrumentation, and Vetronics Visit www.vetlapsurg.com - the internet portal for all aspects of veterinary minimally invasive surgery